National Provider Identifier [NPI]: |
1841212008 |
Last Name Of The Provider |
RIDGE |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
333 COTTMAN AVE |
Street Address 2 Of The Provider |
FOX CHASE CANCER CENTER |
City Of The Provider |
PHILADELPHIA |
Zip Code Of The Provider |
191112434 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
67 |
Number Of Services |
859 |
Number Of Medicare Beneficiaries |
290 |
Total Submitted Charge Amount |
408627 |
Total Medicare Allowed Amount |
134295.4 |
Total Medicare Payment Amount |
100641.34 |
Total Medicare Standardized Payment Amount |
97038.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
67 |
Number Of Medical Services |
859 |
Number Of Medicare Beneficiaries With Medical Services |
290 |
Total Medical Submitted Charge Amount |
408627 |
Total Medical Medicare Allowed Amount |
134295.4 |
Total Medical Medicare Payment Amount |
100641.34 |
Total Medical Medicare Standardized Payment Amount |
97038.14 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
119 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
260 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
262 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.5893 |